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Table 1 Description of the five profiles of people with mild intellectual disability or borderline intellectual functioning (n = 250)

From: Differentiating care for persons with mild intellectual disability or borderline intellectual functioning: a Delphi study on the opinions of primary and professional caregivers and scientists

Profile

n

Description

Most prominent problems

Persons with mild intellectual disability (Profile 1)

85

People in the profile ‘Persons with mild intellectual disability’, experience the least individual, family, and contextual problems. Most people in this profile have a mild intellectual disability and in almost half of the cases a comorbid mild autistic disorder is present. The majority has supportive parents. Individuals in Profile 1 experience few personal, environmental and parental (e.g. financial and mental health) problems. In comparison with the other profiles (3, 4, and 5), individuals in Profile 1 receive relatively less informal support.

- Loneliness due to a small social network

- The demands of the complex, modern society

- Lack of attention from care providers

- Lack of social-emotional skills and a restricted self-image

Males with problem behaviour (Profile 2)

51

Individuals in the profile ‘Males with problem behaviour’ show externalising problem behaviour, often have an addiction to alcohol and/or drugs and have parents experiencing difficulties with raising their child. In comparison with the other profiles (3, 4, and 5), individuals in Profile 2 receive relatively less informal support.

- Comorbidity in which the addiction affects the complexity

- Relapse in addiction

- Restricted self-image and insight

Persons with material hardship and abuse by parents (Profile 3)

47

The profile ‘Persons with material hardship and abuse by parents’ represents mainly women with borderline intellectual functioning who are often a victim of sexual and physical abuse by parents. Some of the people in Profile 3 have a comorbid mood disorder. A small majority of individuals in Profile 3 experience financial problems. The first contact with professional care providers occurs at a relatively high age (M = 23.9 years). Persons in Profile 3 experience relatively more problems with connecting to peers.

- Traumatic and psychiatric problems

- Sexual abuse

- Negative impact of a vulnerable home environment

- Difficulties for professionals to build and maintain a trustful relationship

Male youngsters with problem behaviour and family problems (Profile 4)

37

The profile ‘Male youngsters with problem behaviour and family problems’, includes young men with borderline intellectual functioning displaying externalising problem behaviour, having multiple judicial contacts and who are surrounded by a poor family system. Regarding Profile 4, 100% of the parents are divorced and many parents experienced financial problems; also, the majority of individuals in Profile 4 has been in prison. Compared to the other profiles, persons in Profile 4 received care from the highest number of different healthcare providers (M = 6.5).

- Negative social connections

- Family problems

- Forensic problems

- Behaviour and psychiatric problems

- Inappropriate legislation related to the transition to adulthood and forced treatment

Persons with addictive problems (Profile 5)

30

The profile ‘Persons with addictive problems’ is characterised by adults with MID or borderline intellectual functioning having the most serious individual and family problems of all subtypes. All people in this profile have (had) an addiction to alcohol and/or drugs. Most of these people do not have any daytime activities and no permanent residence, are joining the criminal circuit and have been a victim of physical abuse by parents. Compared with the other profiles, individuals in Profile 5 experience relatively major personal financial problems. Persons in Profile 5 experience relatively more problems with connecting to peers.

- Comorbidity and complexity of the problems

- Addiction

- Lack of structure in daily life

- Negative social connections and contact with criminals

- Lack of confidence in support and care providers

  1. Adapted from “Identifying classes of persons with mild intellectual disability or borderline intellectual functioning: a latent class analysis,” by P.J.G. Nouwens et al., 2017b, BMC Psychiatry, 17, 257